Rapidly Progressive Glomerulonephritis Associated With Anti-glomerular Basement Membrane Disease: A Rare Diagnosis

Anti-glomerular basement membrane disease is a rare small vessel vasculitis caused by the deposition of immunoglobulin G (IgG) autoantibodies in the basement membrane of glomerular capillaries and lung alveoli, leading to rapidly progressive renal failure and/or alveolar hemorrhage. We report the case of an 83-year-old female patient presenting with uremic symptoms, rapidly progressive kidney failure, and a high titer of anti-glomerular basement membrane antibodies. Given the urgent need for kidney replacement therapy, the substantial fibrosis and glomerular scarring observed in the kidney biopsy suggesting a chronic process, and the absence of pulmonary involvement, neither immunosuppressive treatment nor plasmapheresis was initiated, since a low likelihood of a favorable response to these interventions was expected. The patient started intermittent hemodialysis, which resulted in significant clinical improvement. This case highlights the importance of considering anti-glomerular basement membrane disease in the differential diagnosis of rapidly progressive kidney failure, as early diagnosis and timely treatment may be crucial for reducing the risk of progression to end-stage kidney disease.